Health Opinion

Summarising The Main Issues (Immediate And Medium Term) In The COVID-19 Pandemic And Response

By JAYE GASKIA

SETTING THE CONTEXT:

It seems like a long time ago now when the outbreak of the novel corona virus began in Wuhan in China. Yet it has been less than six months, and in that time it has since become the COVID 19 disease, and a pandemic that is now ravaging the whole world, and is changing life and our conditions of living as we know, becoming the most significant existential threat to humanity of the 21st century.
And this just a little over a hundred years since the visitation of it’s distant cousin, the Spanish Flu of 1918; a flu of pandemic proportions that equally ravaged the world.

It is becoming clearer everyday that the pre and post pandemic worlds, with respect to COVID 19, will be very very, if not significantly different worlds.

Since the outbreak of the disease and its morphing into a pandemic, it is becoming increasingly obvious that it’s impact in all of its ramifications is a mirror image of the human civilisation of the 21st century, marked as it is by deep rooted inequality.

The pandemic and the response has been a direct reflection of just how unequal our world is and has become.

Evidence of from the fatalities across the world is showing that the poor and the vulnerable have been the hardest hit.

In Europe for instance 42 to 57% of deaths have been from care homes for the elderly; just as it is also becoming evident that minorities have been disproportionately impacted with respect to infections and fatalities, given their percentages of the overall population.

We are also seeing that lockdowns have had and are having more devastating impacts on the poor and vulnerable, who are the ones who live in slums and crowded housing, and earn their livelihoods from menial jobs, and daily incomes.

So, whereas the disease and the pandemic is neutral in the sense that it does not preselect for any class or group of people, the existing inherent and ingrained inequalities in our world has meant that the burden and impact of the pandemic had been disproportionately distributed and is being unequally borne.

CATEGORIES OF ISSUES:

Given what we know now of the pandemic, it’s impact and the response, globally and nationally, we can summarise the main issues arising from or engendered by the pandemic into about six broad categories.

1. Public Health Issues: the issues around public health include issues around

(a) the pre- pandemic state of healthcare delivery and public health care systems. The state of of the healthcare delivery systems in every country prior to the pandemic plays a strong role in its ability to cope with and respond to the pandemic. It is this preexisting capacity that will underlie the relative resilience of the healthcare delivery systems between and within countries.;

(b) issues around testing capacity, with respect to the availability of well equipped and adequately staffed laboratories to support testing. Virtually every country was caught napping. For instance Nigeria had less than five testing laboratories at the onset of the pandemic, but now had 15. The ability to test, and the capacity to ramp up testing and test as many as possible is key to containing the pandemic and reversing the spread;

(c) isolation and treatment centers are also very key. The capacity to treat those infected depends on the availability and quality of specialised treatment for the disease. Which is why isolation and treatment centers are of extreme importance, and are key to containing the pandemic. The federal and state governments are establishing equipped and staffed isolation and treatment centers, and the private sector coalition against COVID have also announced plans to build, equip and hand over to state governments, isolation and treatment centers in each state of the federation and the FCT;

(d) Social distancing and Self Isolation are two interrelated public health measures being widely implemented. But we do know that it is difficult and nearly impossible to effectively implement social distancing and self isolation in over crowded, slum and barely habitable housing conditions, which is the reality of the poor, and of the overwhelming majority of citizens in a context where over 80% of the population are poor and live in poverty;

(e) hygiene and sanitation are also measures being urged. Thence we are to wash our hands regularly with soap and running water. And herein lies the huge challenge. Access to clean, portable and running water is severely limited before the pandemic, and as we all know, is a function of good, humane and habitable housing conditions. And in a country with 20 million housing deficits, which translates into nearly 120 million citizens living in poor, uninhabitable, and inhumane housing, then this is a very huge challenge indeed;

(f) there are also challenges with the availability of personal protective equipment (PPE) for front line workers in healthcare, but also in security and law enforcement who are enforcing and policing the lockdown, and journalists who are covering the developments, as well as civil society who are undertaking various responses to the pandemic among the unreached, etc;

(g) the Lockdown is a major elephant in the room. It is one of the key public health measures in response to the pandemic, but in a country where the overwhelming majority of citizens are making ends meet in the informal sector, and are dependent on daily incomes, then a lockdown can very quickly become counterproductive, and a huge security risk. The same applies to even the formal sector and big business. Production is shutdown, and economic output grossly reduced. Workers are impacted severely. Similarly as production is impacted so is the distribution and exchange of goods and services.

2. The Palliatives and Stimulus Packages: governments across the world and in Nigeria are also responding with palliatives or subsidies to cushion the impact of the lockdown on the citizenry; and with stimulus packages aimed at keeping businesses afloat and the economy going. The aim is to try to enhance the ability of citizens and economic actors to withstand the impact of the pandemic. However there are issues that are also arising from these measures;

(a) the issue of equity and inclusion in the design, implementation and distribution of palliatives and stimulus packages. Whereas it may be easier to reach big business, the challenge is reaching the MSMEs, the informal sector who are for all intents and purposed undocumented.

How can the state reach those for whom it has no records, either as individual citizens or individual businesses? How can we develop in a participatory, inclusive and rapid manner the records needed to ensure equity and inclusion and fairness in the implementation of these schemes?

Again we go back to the limitations imposed by the nature and character of the preexisting state before the pandemic. And calls into focus the necessity for a biometric and developmental state retooled for effective, quality, and equitable delivery of essential social services as public service.

3. The Economic Impact of the pandemic; there are evidently very grave ramifications of the impact of the pandemic on the economy; just as there are equally evident opportunities for ground breaking, inward looking, pro-people economic reforms. The impact on the economy is primarily threefold in its essence –

(a) the public health impact on the conditions of workers and consumers of goods and services, which in turn impact production, distribution and exchange, and thus affect the bottom line of businesses;

(b) the impact of lockdown and social distancing on ability of businesses to operate and function productively; and

(c) the impact of the inability of businesses to operate on the workers and those employed in the impacted businesses. The cumulative result of all of these are also evidently going to be with respect to closure of businesses, reduced earnings for businesses and government with respect to revenues, potential job losses and layoffs, as well as attempts to reduce workers incomes and salaries. All of these will potentially negatively impact economic growth, widen the inequality gap, and increase poverty levels.

The upside to all if these is that crisis is also an opportunity. The core economic lesson from this pandemic is that we must prioritise and invest in achieving economic self sufficiency, enabling our economy some degree of autonomy from the global economy.

We have a duty to ensure that we ramp up public investment, and incentivise private investment in social capital development – education (that is tied to the economic and national development needs, and is linked to industry); health (effective and efficient and accessible healthcare delivery – primary, secondary and tertiary healthcare, with universal access); Public housing scheme to ensure affordable, accessible humane and habitable housing for all.

The other three categories of issues are crosscutting, and are reviewed below:

4. The question of human rights abuse and violation. It is clear that inequitable access to palliatives and stimulus packages, particularly for those who really need, and whose survival is more undermined by lack of access is a human rights abuse.

Similarly the physical and mental abuse that some are subjected to by law enforcement and security agents in the course of enforcing and policing the lockdown are also human rights violations. And these violations and abuses also have to be checked. Culprits need to be held accountable, and victims need to be redressed and compensated.

5. The question of Transparency and Accountability in the management of the pandemic and the response. For instance the issue of legislative involvement and oversight. Regulations are being issued left right and center.

To what extent are these regulations based in law? What has been the involvement of the legislative assemblies? And more importantly with respect to spendings and stimulus packages, to what extent have these been subjected to legislative appropriation, knowing that the executive cannot spend money that has not been appropriated by the legislature?

There are also transparency and accountability issues in the distribution of palliatives and the targeting of the stimulus packages. How were the criteria for selection determined? Who undertook the assessment process? How was this done? What mechanisms are in place for tracking and monitoring the exercise and ensuring that the support gets to those they are meant for?

In this regard, it is important to clear up one deliberate mix up. The social investment program (SIP) is not, and cannot be a substitute for the palliatives. Whereas the records of the SIP may become part of the framework for designing a palliatives program, it cannot be substituted for it. For starters, the SIP is far too minuscule in scale, even with the instruction to expand by 2 million more to cater adequately for scope of households and persons needing some support in form of palliatives to ensure their resilience to the pandemic.

One minor but significant detail of conceptual clarification is needed Herr before we move on. What the government currently operates is a Social Protection Program, a form of social safety net. It is therefore a component, at the tail end of a proper and comprehensive social investment program – to cater for those who may fall through the cracks.

A social investment program is a comprehensive investment program for social services delivery and social capital development. It is this your integrated investment program for education, healthcare, housing, and other basic social services – water and sanitation, access to energy, roads and communications.

In this sense a social protection program is not a substitute for a social investment program. It is instead a minuscule component at the tail end, to provide for those who may have fallen through the cracks of the wider more comprehensive social investment program.

6. The final category of broad and crosscutting issues is that around Equity and inclusion. That is ensuring equitable access and inclusion of all social categories and population segments in the various responses to the pandemic.

TO CONCLUDE:

In conclusion, we can see that the pandemic has revealed the rotten underbelly of the global capitalist order, the global free trade and market economy order. It has demonstrated the nature, character, but also the scale and scope of the inequality inherent in that system and global order, both with respect to relations and situation between countries, as well as within countries.

Also The enduring and indisputable link between the ability of humanity and the human civilisation to effectively prevent, contain, and overcome infectious diseases and their outbreak; and the housing conditions of people, and their relative level of poverty; has been quite manifestly demonstrated by this pandemic.

The enduring lesson lies in the reaffirmation of the indivisibility of human rights, and the urgent necessity to make all categories of human rights enforceable.

Above all the time has come to revamp the struggle for a New International and National Economic Order; a new socioeconomic order that is based on popular power and popular participation, and one that enables and enhance equity and social inclusion.

In our country Nigeria, we need to refound a state and a governance mechanism that gives meaning and expression to the provisions of Chapter Two of the 1999 Constitution of the Federal Republic of Nigeria; a chapter that envisages developmental state that prioritises the provision of social services to her people, that guarantees the security and wellbeing of citizens.

As a country, we also need to invest in the national economy, to prioritise developing and enhancing local, that is national production, distribution and exchange capacities.

Jaye Gaskia is Director, Praxis Center; and Convener, Take Back Nigeria Movement (TBN).

 

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